Factors affecting the rate of iron mobilization during venesection therapy for genetic hemochromatosis

Although progressive iron accumulation is a characteristic feature of genetic hemochromatosis, the factors affecting the rate of iron mobilization by venesection have not been established. Venesection records were analyzed in 77 hemochromatosis homozygotes to study the factors affecting the rate of iron mobilization by venesection. The rate of iron mobilization was the iron removed divided by the time required to deplete iron stores (serum ferritin < 50 microg/L). Mean duration of venesection therapy was 1.4 years (range 0.44-3.6 years). All patients completed the therapy and there were no significant adverse effects. Rate of iron mobilization was higher in cirrhotics compared to non-cirrhotic patients (P = 0.04). Iron mobilization was inversely related to intestinal radioiron absorption (r = -0.45, P = .01). There was no significant relationship between iron mobilization and patient age, gender, serum ferritin, and hepatic iron concentration. Iron mobilization is increased in cirrhotics and patients with lower intestinal iron absorption. Venesection therapy is safe and well tolerated in all age groups.